44 home caregiver jobs found

Become a part of our caring community and help us put health first The Director, Home Health Risk Management identifies and analyzes potential sources of risk, proactively ensuring controls and processes are in place to reduce risk. The Director, Home Health Risk Management requires an in-depth understanding of how organization capabilities interrelate across the Home Health segment. The Director of Risk Management for Home Health will be responsible for development and implementation of controls and cost-effective approaches to minimize risks to the organization as well as estimating the potential consequences of risks. Assesses and communicates information regarding business risks with functions across the organization. Their focus will be on CenterWell risk assessments, issue management, auditing and monitoring. Areas of oversight will include CenterWell Home Health, OneHome, as well as new growth initiatives. This role requires an in-depth understanding of Home Health...

Become a part of our caring community and help us put health first Encounter Data Management Professional is responsible for ensuring accurate submission and reconciliation of encounter data to Medicaid and Medicare through effective business processes. Ensures claims submissions meet or exceed all compliance standards via analysis of data and develops tools to enhance the encounter acceptance rate by Medicaid/Medicare. Looks for long-term improvements of claims submission processes. Takes ownership by applying professional standards, regulations, and strategies within their work area. Independently sets priorities and makes decisions on work approach while following established direction. Work is managed and often guided by precedent and/or documented procedures/regulations/professional standards with some interpretation. Humana's Encounter Data Management (EDM) team is seeking an Encounter Data Management Professional that has experience with business processing and data...

Become a part of our caring community and help us put health first Care Manager Support Assistants assist in ensuring TRICARE beneficiaries receive the highest quality health care for Autism Spectrum Disorder (ASD) related services in accordance with the Autism Care Demonstration (ACD). This role supports the Autism Service Navigator (ASN) by verifying eligibility for the ACD and monitoring and supporting the family for 180 to assist with any barriers to accessing services; education and initial registration into ECHO registration portal for active duty family members; assistance with regional transfers and ensuring the receiving Managed Care Support Contractor receives the appropriate paperwork; processes faxes for ECHO eligibility or other paperwork pertaining to ACD requirements such as eligibility, referrals, etc.; and identification of ABA providers and researching necessary resources to support the beneficiary. KEY ACCOUNTABILITIES Assist beneficiaries with...

Become a part of our caring community and help us put health first The Workforce Management Professional 1 applies and integrates advanced and predictive analysis, people metrics and reporting to develop strategic and operational insights for workforce decision-making (e.g., staffing, learning and development, talent management, diversity and human resource compliance). The Workforce Management Professional 1 work assignments are often straightforward and of moderate complexity. The Workforce Management Professional 1 assesses organizational staffing and identifies requirements and solutions to meet workforce objectives. Provides analysis of talent and staffing needs based on strategic planning at the enterprise level. Understands own work area professional concepts/standards, regulations, strategies and operating standards. Makes decisions regarding own work approach/priorities, and follows direction. Work is managed and often guided by precedent and/or documented...

Become a part of our caring community and help us put health first Humana is evolving its marketing operations to enable smarter planning, faster execution, and greater transparency-and we're looking for a product manager to lead that effort. As Senior Associate/Product Manager - Marketing Resource Management (MRM) Capabilities, you'll own the roadmap for tools and workflows that support campaign intake, planning, approvals, and performance tracking. This role is central to enabling scalable, compliant, and insight-driven marketing operations. You'll help guide the transition to a modern resource management platform and evaluate opportunities to integrate with enterprise workflow systems to support intelligent orchestration. This role supports the day-to-day configuration and optimization of marketing resource management tools and workflows. You'll work closely with cross-functional teams-including Marketing, Creative, Legal, and IT-to ensure campaign planning and...

Become a part of our caring community and help us put health first With over 10 million sales interactions annually, Humana understands that while great products are important, it's the quality of our service that truly defines us. We know that when our members and prospects have delightful and memorable experiences, it strengthens their connection with us and enables us to put their Health First. After all, a health services company that has multiple ways to improve the lives of its customers is uniquely positioned to put those customers at the center of everything it does. The Lead Product Owner is responsible for conveying product vision and roadmap to an Agile delivery team by defining user stories and prioritizing product backlog. The Lead Product Owner works on problems of diverse scope and complexity ranging from moderate to substantial. This role will be aligned to Humana sales technology platforms, helping further advance capabilities that provide a seamless...

Become a part of our caring community and help us put health first The Senior Workforce Management Professional applies and integrates advanced and predictive analysis, people metrics and reporting to develop strategic and operational insights for workforce decision-making (e.g., staffing, learning and development, talent management, diversity and human resource compliance). The Senior Workforce Management Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. The Senior Forecasting Analyst plays a pivotal role in shaping strategic workforce planning through advanced forecasting methodologies, comprehensive data analysis, and insightful consultation. This position is responsible for overseeing and refining staffing forecasts, optimizing resource allocation for contact center and back-office operations, and driving continuous improvement in workforce management...

Become a part of our caring community and help us put health first The Associate Director, Finance Data Management supports all aspects of configuration control, data management, and deficiency reporting. The Associate Director, Finance Data Management requires a solid understanding of how Finance organization data capabilities interrelate across department(s). The Associate Director, Finance Data Management supports implementation of government and industry policies for requirements management, document management, change management, production and delivery, and configuration management of the performance, functional, and physical baselines. Acquires, validates, stores, protects, and processes required data to ensure the accessibility, reliability, and timeliness of the data for its users. Develops and executes architecture, policies, practices and procedures that properly manage the full data lifecycle needs of an enterprise. Decisions are typically related to identifying...

Become a part of our caring community and help us put health first The Staff Utilization Management Pharmacist is a clinical expert responsible for conducting medical necessity and comprehensive medication reviews for prescriptions requiring prior authorization. This role involves evaluating complex clinical scenarios and applying evidence-based criteria to ensure appropriate medication use. The pharmacist addresses moderately complex to complex issues that require critical thinking and in-depth analysis of variable factors. Earn a $5,000 hiring bonus! Bonus is paid after 180 days of employment; you must be employed until that date to be eligible to receive the payment." Location: Remote - United States Schedule: 8-hour shifts, Monday through Friday, between 10:30 AM and 11:00 PM EST OR 10-hour shifts, Tuesday through Friday, between 10:30 AM and 11:00 PM EST Required to work every 5th Saturday Required to work 1 company holiday...

Become a part of our caring community and help us put health first We are looking for a dynamic Lead Product Manager to develop clinical solutions for our members and providers, with full accountability from strategy to execution. The Lead Product & Strategy Manager - Provider Practice Management role is a critical member of the multidisciplinary clinical initiatives team within Clinical Strategy and Analytics. This role is not a traditional software product manager role. Instead, it requires demonstrated expertise in healthcare delivery, provider performance improvement, operational redesign, and translating insights into actionable workflows for clinical practices. The Lead Product & Strategy Manager will work across clinical initiatives focused on reducing 30-day Plan All-Cause Readmissions (PCR). They will partner closely with high-performing and low-performing provider groups to identify clinical best practices, understand operational gaps, and design and...

Become a part of our caring community and help us put health first Join Humana as a Case Manager and make a real difference within the Inclusa/Humana team, serving members in the Wisconsin Family Care (FC) program. In this dynamic role, you will collaborate closely with dedicated colleagues to deliver exceptional care and empower our members to thrive in their daily lives. As a Case Manager, you will provide comprehensive social service care management to frail elders and adults with intellectual, developmental, or physical disabilities who qualify for Wisconsin's FC program. Bring your compassion and expertise to help members access vital resources, promote independence, and enhance their quality of life within their communities. Key responsibilities: Assess members to identify their strengths, interests, and preferences, focusing on health and safety needs to develop a comprehensive Member Care Plan (MCP). Coordinate services that address members' health and...

Become a part of our caring community and help us put health first The Manager, Fraud and Waste conducts investigations of allegations of fraudulent and abusive practices. The Manager, Fraud and Waste works within specific guidelines and procedures; applies advanced technical knowledge to solve moderately complex problems; receives assignments in the form of objectives and determines approach, resources, schedules and goals. Where You Come In The Manager, Fraud and Waste coordinates investigation with law enforcement authorities. Assembles evidence and documentation to support successful adjudication, where appropriate. Conducts on-site audits of provider records ensuring appropriateness of billing practices. Prepares complex investigative and audit reports. Decisions are typically related to resources, approach, and tactical operations for projects and initiatives involving own departmental area. Requires cross departmental collaboration, and conducts briefings and...

Become a part of our caring community and help us put health first Join Humana as a Case Manager and make a real difference within the Inclusa/Humana team, serving members in the Wisconsin Family Care (FC) program. In this dynamic role, you will collaborate closely with dedicated colleagues to deliver exceptional care and empower our members to thrive in their daily lives. As a Case Manager, you will provide comprehensive social service care management to frail elders and adults with intellectual, developmental, or physical disabilities who qualify for Wisconsin's FC program. Bring your compassion and expertise to help members access vital resources, promote independence, and enhance their quality of life within their communities. Key responsibilities: Assess members to identify their strengths, interests, and preferences, focusing on health and safety needs to develop a comprehensive Member Care Plan (MCP). Coordinate services that address members' health and...

Become a part of our caring community and help us put health first Join Humana as a Case Manager and make a real difference within the Inclusa/Humana team, serving members in the Wisconsin Family Care (FC) program. In this dynamic role, you will collaborate closely with dedicated colleagues to deliver exceptional care and empower our members to thrive in their daily lives. As a Case Manager, you will provide comprehensive social service care management to frail elders and adults with intellectual, developmental, or physical disabilities who qualify for Wisconsin's FC program. Bring your compassion and expertise to help members access vital resources, promote independence, and enhance their quality of life within their communities. Key responsibilities: Assess members to identify their strengths, interests, and preferences, focusing on health and safety needs to develop a comprehensive Member Care Plan (MCP). Coordinate services that address members' health and...

Become a part of our caring community and help us put health first Join Humana as a Case Manager and make a real difference within the Inclusa/Humana team, serving members in the Wisconsin Family Care (FC) program. In this dynamic role, you will collaborate closely with dedicated colleagues to deliver exceptional care and empower our members to thrive in their daily lives. As a Case Manager, you will provide comprehensive social service care management to frail elders and adults with intellectual, developmental, or physical disabilities who qualify for Wisconsin's FC program. Bring your compassion and expertise to help members access vital resources, promote independence, and enhance their quality of life within their communities. Key responsibilities: Assess members to identify their strengths, interests, and preferences, focusing on health and safety needs to develop a comprehensive Member Care Plan (MCP). Coordinate services that address members' health and...

Become a part of our caring community and help us put health first Join Humana as a Case Manager and make a real difference within the Inclusa/Humana team, serving members in the Wisconsin Family Care (FC) program. In this dynamic role, you will collaborate closely with dedicated colleagues to deliver exceptional care and empower our members to thrive in their daily lives. As a Case Manager, you will provide comprehensive social service care management to frail elders and adults with intellectual, developmental, or physical disabilities who qualify for Wisconsin's FC program. Bring your compassion and expertise to help members access vital resources, promote independence, and enhance their quality of life within their communities. Key responsibilities: Assess members to identify their strengths, interests, and preferences, focusing on health and safety needs to develop a comprehensive Member Care Plan (MCP). Coordinate services that address members' health and...

Become a part of our caring community and help us put health first Join Humana as a Case Manager and make a real difference within the Inclusa/Humana team, serving members in the Wisconsin Family Care (FC) program. In this dynamic role, you will collaborate closely with dedicated colleagues to deliver exceptional care and empower our members to thrive in their daily lives. As a Case Manager, you will provide comprehensive social service care management to frail elders and adults with intellectual, developmental, or physical disabilities who qualify for Wisconsin’s FC program. Bring your compassion and expertise to help members access vital resources, promote independence, and enhance their quality of life within their communities. Key responsibilities: Assess members to identify their strengths, interests, and preferences, focusing on health and safety needs to develop a comprehensive Member Care Plan (MCP). Coordinate services that address members’ health and safety...

Become a part of our caring community and help us put health first Enjoy a rewarding career with a true work/life balance—no nights or weekends, giving you more time for what matters most. Humana is currently seeking RN Case Managers to join our teams in the La Crosse and Sparta offices, serving members in the Wisconsin Family Care (FC) program. In this vital role, you will collaborate with dedicated colleagues to ensure exceptional care coordination for our members, providing crucial support and education to help them thrive in their daily lives. Take the next step in your nursing career and make a meaningful difference with Humana. Key responsiblities: Partner with a Care Coach (also referred to as a Case Manager), taking the lead on health-related needs, to collaborate on an ongoing basis regarding the member and their care plan. Conduct regular health assessments for members and implement appropriate strategies and services to develop individualized...

Become a part of our caring community and help us put health first The Compact licensed telephonic Care Manager works from home in a call center environment. They assess and evaluate members' needs and requirements to achieve or maintain optimal wellness by providing care coordination and facilitating member or family interaction with resources appropriate for the care and wellbeing of the member. Job Description Humana Care Support is a division of Humana dedicated to helping adults remain independent in their homes. Our nurses are called Care Managers, because our case management services are centered on the person rather than the condition. The Care Manager uses a range of strategies and techniques to manage a member's physical, environmental, and psycho-social health issues. They identify and resolve barriers to effective care and continuously monitor progress through assessments and evaluations to ensure members achieve their desired health outcomes. Role...

Become a part of our caring community and help us put health first Humana is seeking an RN Care Manager (Health & Wellness Coordinator) to join the Inclusa team to serve members in the Wisconsin Family Care (FC) program. As a Health & Wellness Coordinator (HWC) you will be responsible for partnering with your fellow colleagues to provide top quality coordination of care to our members. They are looking to you in providing assistance when it comes to living their daily lives. The HWC is responsible for facilitating the coordination, communication, negotiation, and collaboration of streamlined healthcare delivery processes on behalf of the member. Key Responsibilities: Partner with a social services care manager (also referred to as a Community Resource Coordinator) and collaborate on an ongoing basis regarding the member and their plan. Perform face-to-face health-related assessments for members upon enrollment and at least every six (6) months thereafter...

Become a part of our caring community and help us put health first Enjoy a rewarding career with a true work/life balance-no nights or weekends, giving you more time for what matters most. Humana is currently seeking an RN Case Manager to join our team, serving members in the Wisconsin Family Care (FC) program. In this vital role, you will collaborate with dedicated colleagues to ensure exceptional care coordination for our members, providing crucial support and education to help them thrive in their daily lives. Take the next step in your nursing career and make a meaningful difference with Humana Key responsibilities: Partner with a Care Coach (also referred to as a Case Manager), taking the lead on health-related needs,to collaborate on an ongoing basis regarding the member and their care plan. Conduct regular health assessments for members and implement appropriate strategies and services to develop individualized care plans that support their continued...

Become a part of our caring community and help us put health first Enjoy a rewarding career with a true work/life balance-no nights or weekends, giving you more time for what matters most. Humana is currently seeking RN Case Managers to join our teams in the La Crosse and Sparta offices, serving members in the Wisconsin Family Care (FC) program. In this vital role, you will collaborate with dedicated colleagues to ensure exceptional care coordination for our members, providing crucial support and education to help them thrive in their daily lives. Take the next step in your nursing career and make a meaningful difference with Humana. Key responsiblities: Partner with a Care Coach (also referred to as a Case Manager), taking the lead on health-related needs, to collaborate on an ongoing basis regarding the member and their care plan. Conduct regular health assessments for members and implement appropriate strategies and services to develop individualized care...

Become a part of our caring community and help us put health first Humana is seeking an RN Care Manager (Health & Wellness Coordinator) to join the Inclusa team to serve members in the Wisconsin Family Care (FC) program. As a Health & Wellness Coordinator (HWC) you will be responsible for partnering with your fellow colleagues to provide top quality coordination of care to our members. They are looking to you in providing assistance when it comes to living their daily lives. The HWC is responsible for facilitating the coordination, communication, negotiation, and collaboration of streamlined healthcare delivery processes on behalf of the member. Key Responsibilities: Partner with a social services care manager (also referred to as a Community Resource Coordinator) and collaborate on an ongoing basis regarding the member and their plan. Perform face-to-face health-related assessments for members upon enrollment and at least every six (6) months thereafter...

Become a part of our caring community and help us put health first The Senior Product Manager Conceives of, develops, delivers, and manages products for customer use. The Senior Product Manager work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. Senior Product Manager is a senior individual contributor who orchestrates complex, cross-platform technology initiatives that advance enterprise strategy and operational reliability. As a Senior Product Manager, you will plan and manage the enhancement and/or integration of the business products with a special focus on clinical care management and technology solutions. This role is pivotal in translating business vision into scalable technology solutions, ensuring seamless integration across platforms such as clinical care management platforms, telephony, data systems, and enterprise architecture. The Senior Product Manager will...